1
What do we know about KY numbers? 1997 report from 37 Public Health Clinics –1/3 reported drinking in past month –over 40% reported ever using illicit drugs with higher numbers for current use in 11 - 17 year olds

3
Why focus so much attention on effects associated with prenatal alcohol exposure?

4
Fetal Alcohol Syndrome Fetal alcohol syndrome is among the most commonly known causes of mental retardation and is a major public health problem. It is the leading preventable cause of mental retardation!

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Historical view of alcohol as a teratogen Foolish, drunken, or harebrain women most often bring forth children like unto themselves Aristotle in Problemata Rosett, 1984

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Historical view of alcohol as a teratogen Foolish, drunken, or harebrain women most often bring forth children like unto themselves Aristotle in Problemata Behold, thou shalt conceive and bear a son: And now, drink no wine or strong drink. Judges 13:7 Rosett, 1984

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2 1 3 1 2 3 Group 0 2 4 6 Rule Violations NC PEA FAS P<0.001 Move only one piece at a time using one hand and never place a big piece on top of a little piece Starting position Ending position Mattson, et al., 1999 Executive functioning deficits

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Secondary Disabilities Individuals with FAS/FAE have a range of secondary disabilities – disabilities that the individual is not born with, and which could be ameliorated withappropriate interventions. Streissguth, et al., 1996

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Smoking and nicotine during pregnancy 25-35% of women smoke cigarettes during pregnancy although clearly there are regional differences Cigarette smoking during pregnancy is one of the most important preventable risk factors for SGA pregnancies, as well possibly for late fetal death

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cocaine and methamphetamine no classic withdrawal syndrome –increased reactivity - cocaine idea of cumulative risk not as much known about methamphetamine – –preliminary data that smoked is associated with reduced birth weight

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marijuana Fried (Ottawa study) –data – mixed; –possible cognitive effects although varies with age and may be related to polydrug interactions